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29 Cards in this Set
- Front
- Back
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1. What are two sources of odor in the mouth?
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1. Sulfur compounds
2. Disease (oral and/or systemic) **important to know why patient uses mouthwash so can identify source of bad breath |
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2. How large are fine aerosols generated by high-speed dental equipment?
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Moisture droplets and debris usually .5mm or less in diameter
They can remain suspended in the air W/o protection aerosols may reach the lower lobes of the lungs |
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3. How large are splatter droplets?
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50mm in diameter and can acts as projectiles
**Both aerosols and splatter droplets can contain infectious agents as the diameter of a bacterial cell is about.1mm and that of a virus is much smaller |
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4. Why do we do pre-procedure rinses?
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It is reasonable to assume that any method fro reducing the viable bacterial content of aerosols could lower the risk of cross-contamination in dental operatorys
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5. What are the active ingredients in mouthwash?
Six... |
1. Alcohol
2. Chlorhexidine Gluconate (CHX) 3. Phenols 4. Quaternary Ammonium Compounds 5. Sanguinarine 6. Oxygenating Agents |
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6. What is the alcohol content of mouthwashes?
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Listerine: 27% alcohol 54 proof
Scope: 19% alcohol 38 proof |
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7. What is chlorhexidine used for?
Who is it used with? |
1. Adjunct to toothbrushing
2. Intermaxillary fixation 1. Post-surgical patients 2. Orthodontic therapy 3. Physically and mentally challenged patients 4. Oral manifestations of systemic disease |
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8. What is CHX used against?
What does it miss? |
Bactericidal against gram-positive and gram-negative bacteria and yeasts
Anti-viral activity |
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9. What is CHX's antibacterial activity associated with?
How does it do this? |
It's adsoprtion by bacteria
At neutral pH CHX is positively charged molecule It is absorbed on the surface of the bacteria where it reacts w/ negatively charged membrane components |
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10. How is CHX under acidic conditions?
What does CHX do at low concentrations? What does it do at high concentrations? |
Adsorption decreases resulting in a reduced anti-bacterial effect
Causes disorganization of cytoplasmic membrane making bacteria permeable to drug which inhibits essential metabolic events Coagulates cytoplasmic constituents and prevents the bacterial cells from recovering |
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11. How is CHX delivered?
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In rinsing solutions, mainly 0.2 and 0.1 (0.12%) and in a 1% gel
Also delivered in slow release devices such as varnishes, fibers, and chip-like sustained delivery devices Can be incorporated into gum |
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12. What are local side effects of chlorhexidine?
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1. Extrinsic stain
-easily removed via local polishing 2. Gradual change in taste -taste changes to bitter -return to normal after discontinuing CHX |
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13. Is CHX useful with subgingival irrigation?
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CHX does not penetrate into the gingival pocket
No long lasting effect of CHX by teeth exposed to a single episode of pocket irrigation have been demonstrated |
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14. Is CHX useful w/ subgingival irrigation?
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Use of 0.2% CHX 2x daily in a pulsated jet irrigator as part of daily dental home-care measure after scaling
Can be effective at reducing plaque deposition, periodontal inflammation, and probing pocket depths in patients w/ adult periodontitis |
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15. Who was Joseph Lister?
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Physician who promoted idea of sterile surgery
Infection was principal cause of death after surgery and he decided to try to use chemical agents to prevent this |
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16. What did Lister use as a disinfectant?
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Carbolic acid (phenol)
This greatly reduced the death rate from post-operative infections **father of modern antisepsis |
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17. What happened to using phenol?
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Continual exposure to phenol could be unpleasant
Realized better to prevent bacteria from getting into wounds in first place: rise of sterile surgery |
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18. By how much does CHX reduce the bacterial account?
Who is mouthwash not good for? |
95% in 45 minute time span
Not good for... 1. people with dry mouth 2. Old 3. Medically complicated |
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19. What did short-term studies reveal about rinsing with Listerine (oldest oral product)?
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Statistically significant reductions (35%) in levels of plaque and gingivitis regardless of oral hygiene
**Study was done in 70's |
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20. What is triclosan?
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Bisphenol and nonionic germicide w/ low toxicity and a broad spectrum of anti-bacterial activity
**Widely sold in Europe and under regulatory review in US |
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21. What is triclosan used in?
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Soaps, antiperspirants, and cosmetic toiletries
Data on effectiveness of oral products containing triclosan to reduce plaque, gingivitis, and calculus and to maintain gingival health |
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22. What are quaternary ammonium compounds?
What do they share in common with CHX bisbiguanides? |
Group of cationic surface active agents
Tendency to bind to oral tissues, due largely to their strong positive charge |
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23. Are they as effective as CHX?
Why or why not? |
No
Their initial attachment is strong but they are released from the binding sites at a much more rapid rate than CHX |
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24. What is the most commonly used quaternary ammonium compounds?
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CPC (cetylpyridinium chloride)
Usually used at 0.05% and sometimes w/ domiphen bromide (Scope) **better for older patients |
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25. What are the side effects of quaternary ammonium compounds?
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1. Staining
2. Enhanced calculus formation *both of these esp if at higher concentrations 3. Burning sensation 4. Occasional desquamation |
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26. What is the recommendation for using this group of mouth rinses>
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Twice daily rinses
Formulated in a 14 to 18% alcoholic vehicle at a pH of 5.5 to 6.5 **They do not carry ADA acceptance for reduction in plaque and gingivitis |
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27. What is sanguinarine used in?
What is it? What is the current formulation? |
Mouth rinse and toothpaste as an anti-plaque/gingivitis agent
Alkaloid extract Contains the extract at 0.03% and 0.2% zinc chloride to enhance the anti-plaque effect |
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28. What is viadent mouthwash a risk for developing?
What have oxygenating agents been used for? |
Oral leukoplakia
Agents such as peroxides and perborates have been used in the past primarily in the short-term treatment of acute necrotizing ulcerative gingivitis and pericornotits |
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29. In recent years what has hydrogen peroxide been recommended for?
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In combination w/ sodium chloride and sodium bicarbonate in a paste form or in an irrigator in the treatment of periodontal disease
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